Patient default risk as a barrier for achieving organisational excellence

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HIV/AIDS is the world's most urgent public health challenge. It is the leading cause of death for young adults worldwide. There is as yet no vaccine and no cure. The high unemployment rate and poverty experienced in South Africa contribute to the high HIV/AIDS infection levels experienced in the country. With the vast majority of HIV/AIDS cases and the growth in the number of people infected who will look towards publicly funded hospitals for medical care, the financial strain on government hospitals and pharmacies will be severe, not only as a result of the sheer number of people seeking healthcare, but also because healthcare for HIV/AIDS patients is more expensive than for most other conditions. Antiretroviral treatment is the main type of treatment for HIV/AIDS. It is not a cure, but it can stop people from becoming ill for many years. The treatment consists of drugs that have to be taken every day for the rest of a patient's life. Antiretroviral treatment has complex and rigorous dosing requirements. The aim of antiretroviral treatment is to keep the amount of HIV/AIDS in the body at a low level. This stops any weakening of the immune system and allows it to recover from any damage that HIV/AIDS might have caused already. Medication compliance means taking the medications exactly as prescribed by the doctor for the amount of time intended. Medication noncompliance, on the other hand, means taking medications in any way other than what the doctor prescribed. While noncompliance may not seem like a big deal, it can have serious consequences. The challenge of optimizing adherence to anti-retroviral treatment remains paramount in the treatment of HIV/AIDS. The purpose of this study is to establish the cost of a patient defaulting anti-retroviral treatment per month, and to determine the financial and economic impact that defaulting patients has on General de la Rey and Thusong Hospital Complex Pharmacies. The study further aims to prove that the risk of patient defaulting is a barrier to achieve organisational excellence through healthcare delivery.